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Adult liver transplantation: An analysis of the early causes of death in 40 consecutive cases

Cuervas Mons, V and Martinez, AJ and Dekker, A and Starzl, TE and Van Thiel, DH (1986) Adult liver transplantation: An analysis of the early causes of death in 40 consecutive cases. Hepatology, 6 (3). 495 - 501. ISSN 0270-9139

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Abstract

One hundred twenty‐nine adult patients who received an orthotopic liver transplantation and survived at least 24 hr after surgery were evaluated. During the period of follow‐up, 48 of the 129 patients (37%) died. Only 40 of these 48 patients died at our institution and were included in this study. Seventeen of the 40 deaths (42.5%) occurred during the first month after orthotopic liver transplantation and 30 of the 40 deaths (75%) occurred during the first 60 days post‐orthotopic liver transplantation. Death was related to infection in 21 cases (52.5%), to multiorgan failure in 8 (20%) and to uncontrollable rejection in 3 (7.6%). The remaining eight deaths (20%) were attributed to a variety of other causes. Eleven of the 21 deaths related to infection (52%) occurred during the first month after orthotopic liver transplantation. Bacterial sepsis was the leading cause of death and accounted for 17 of the 21 deaths (81%) in which infection was present at the time of death. The most frequently isolated bacteria were Pseudomonas and other enteric Gram‐negative bacilli. Three patients had complete occlusion of the hepatic artery of the grafted liver. Six patients developed massive infarction of the liver despite patent vascular anastomoses. Histological signs of rejection were seen in 9 of the 31 patients autopsied (29%), but in only 3 of these (9.6%) was rejection the principal cause of death. The biliary anastomoses were patent in all 31 cases examined at autopsy. Copyright © 1986 American Association for the Study of Liver Diseases


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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Cuervas Mons, V
Martinez, AJ
Dekker, A
Starzl, TEtes11@pitt.eduTES11
Van Thiel, DH
Centers: Other Centers, Institutes, or Units > Thomas E. Starzl Transplantation Institute
Date: 1 January 1986
Date Type: Publication
Journal or Publication Title: Hepatology
Volume: 6
Number: 3
Page Range: 495 - 501
DOI or Unique Handle: 10.1002/hep.1840060329
Institution: University of Pittsburgh
Refereed: Yes
ISSN: 0270-9139
Other ID: uls-drl:31735062119684, Starzl CV No. 682
Date Deposited: 08 Apr 2010 17:11
Last Modified: 02 Feb 2019 14:55
URI: http://d-scholarship.pitt.edu/id/eprint/4068

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